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Since Shelby Regional Medical Center closed in July, Jana Danley and others have petitioned elected officials to help re-establish ER services in the town of Center. The closest hospital is now 21 miles away.

A government shutdown of sorts persists in East Texas.

State and local officials representing Shelby County are still resisting any organized effort to try to remedy the loss of the region’s only emergency room, despite pleas from residents. They also have tried to keep a lid on a public dialogue.

Two months after 18-month-old Edith Gonzalez died needlessly – her parents had nowhere to turn after she choked on a grape – residents of Center continue to petition elected leaders for action. They have collected more than 1,500 signatures asking officials to help reopen Shelby Regional Medical Center or lure a temporary ER facility to town.

The response? Only brief emails or letters have come back from the offices of state Rep. Chris Paddie and Sen. Robert Nichols, noting that they are monitoring the situation. At the local level, city and county officials have avoided calling a town hall meeting to solicit ideas. Nor have they pooled their agencies’ resources to study options.

“How can there be a town hall meeting coming up for a local water tax issue, but not one to address life-saving ER care?’’ said Jana Danley, a former nurse at Shelby Regional Medical Center, which closed in July, leaving the nearest ER facility 21 miles away.

Lt. Gov. David Dewhurst’s office said today that he is likely to order the legislature to investigate the fallout tied to Dr. Tariq Mahmood’s operation of Shelby and his five other rural hospitals. The move would be part of his “interim charges” to lawmakers — a process that helps set the agenda before the next session begins in 2015.

The Texas hospital chain collapsed in recent months amid a government crackdown on substandard care and questionable management practices. Gov. Rick Perry ordered an investigation of his facilities and regulatory failures to rein him in following my investigation of the problems. Mahmood, a Dallas-area businessman, is under federal indictment for billing fraud. He denies wrongdoing. A trial is set for early November.

Sen. Judith Zaffirini, D-Laredo, requested the Dewhurst order for consideration of a “range of policy changes,” including creating a conservatorship program to keep troubled hospitals operating. A Dewhurst spokesman told me “there’s no reason to believe (Zaffirini’s request) wouldn’t be included” among the interim charges.

But Zaffirini said she’s disturbed that Shelby County’s elected officials aren’t pulling together to solve the immediate ER dilemma. She said she hopes those leaders can start working “swiftly and collaboratively.’’

“Leaders who believe that health care is a privilege, not a right, may dismiss this problem as beyond their scope of responsibility,’’ she said. “We who believe that health care is a right respectfully disagree.”

Zaffirini said her “heart goes out to the Gonzalez family.” The toddler’s death “illustrates how access to health care truly can mean the difference between life and death,’’ she said.

Paddie and Nichols have repeatedly declined my requests for interviews.

Shelby County and Center officials have said in recent weeks they are hesitant to get into the hospital business. They say, for example, they are opposed to forming a taxing district to help fund an ER operation, and that residents wouldn’t go for additional taxes.

County Judge Rick Campbell, who previously said he’s reluctant to get county government involved in private health care matters, stressed to me this week that he’s aware of citizens’ worries. He said he had private discussions with various medical professionals and state officials back in August, but no obvious solutions emerged.

He also said he’s trying to plan a meeting in coming days with concerned local doctors to explore the possibility of luring a temporary ER to town.

As for a town hall meeting with the public?

“I just don’t know,” he said, adding he doesn’t think other county officials would go for it.

Update at 1:13 p.m. Federal regulators just confirmed that Renaissance Hospital Terrell has been shut down in the wake of recent patient-care breakdowns that included two deaths.

“There are no staff or patients in the facility, and it is not providing any care at all,” according to a statement CMS sent me moments ago.

Agency officials are now trying to notify Kaufman County residents that they have several care options within 25 miles of Terrell that I’ve listed at the bottom of this post in bold.

Original item at 12:17 p.m. In a rare action, federal and state health regulators are moving to shut down Renaissance Hospital Terrell for recklessly endangering patients, including nursing failures they say led to two deaths.

As of midnight, the lone hospital serving Terrell, southeast of Dallas in Kaufman County, became only the ninth hospital in the U.S. during the last three years to see its funding cut off by the U.S. Centers for Medicare & Medicaid Services, records show. And it’s only the fifth time since 2007 the Texas Department of State Health Services has moved to revoke a hospital’s license, that agency says.

We’re still trying to piece together the facts. But a January inspection report I obtained from CMS shows the 102-bed hospital – owned by RH Terrell Management LLC, as listed in state records – has violated 15 safety regulations in recent months, placing patients in the most serious threat category, “immediate jeopardy.’’